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Patient numbers at Vavuniya hospital stabilized this past weekend as new arrivals were diverted to other hospitals. MSF has offered to scale up its medical activities and is currently in talks with authorities to do so.

The Doctors Without Borders/Médecins Sans Frontières (MSF) and Ministry of Health medical staff at Vavuniya hospital continued to work around the clock this past weekend. Patient numbers stabilized at 1,700, as some injured are now being diverted to other hospitals. MSF has offered to scale up its medical activities and is currently in discussions with Sri Lankan authorities to get permission to do so.

The thousands of people who were waiting at Omanthai checkpoint on Friday have now been transferred to Manik Farm, an open area with temporary camps about 25 miles southwest of Vavuniya. There are now a total of 100,000 displaced people at Manik Farm and bulldozers are clearing land to make space for new arrivals.

Paul McMaster, an MSF surgeon working at Vavuniya hospital, described the situation on the night of April 26.

Medical staff are still working around the clock and the situation is changing day to day. The number of patients admitted requiring emergency surgery dropped quite sharply before the weekend. On April 23 we had 44 new patients, the first day the figure was below 100 since last Sunday. On April 24 we only had 18.

I have had no indication that fewer casualties are coming from the north, but because we have a backlog they are now trying to divert patients to other hospitals.

There are still people crowded in the wards, in the corridors, on the floor—with fractures, open bullet wounds and blast injuries. There are many people who have been waiting on the wards to go into theatre, some of them for up to 24 hours.

On Saturday, Tim—the other MSF surgeon—and the Sri Lankan team that arrived last Thursday were in theatre until late at night getting through the backlog of cases.

I spent the whole of yesterday seeing hundreds and hundreds of patients, examining x-rays, stitching wounds, plastering, getting people on crutches and mobile, and teaching physiotherapy to nurses. There is only one physiotherapist for the whole hospital.

Today, Tim stayed in the hospital and I went with other colleagues to Mannar hospital, in the west, to see if they can help with our casualties. All hospitals are really struggling. Mannar hospital has 350 beds for almost 1,000 patients and some of them are in tents outside the hospital building.

We also drove to Manik Farm today, 40 kilometers (about 25 miles) southwest of Vavuniya. There are now 100,000 displaced people. Bulldozers are clearing more land to make more room. We went to assess the needs and see what MSF can do there. One man who had arrived at Manik Farm from the north a few days ago came up to us saying “I have nothing, I have nothing.” He was just standing there, shell-shocked, just telling us “I have nothing.”

I am in Vavuniya this evening and it is pouring with rain so if it is raining like this in Manik Farm, the camps will turn into mud baths.

This weekend we have nearly cleared the surgical backlog and the Sri Lankan surgical team left earlier today. We might be getting another one later this week.

I’ve not heard that the fighting is stopping and I don’t know how many more wounded will come but we are ready for the next wave, if it comes. We take each day as it comes.